545620287-11-8-2023-57-CC-CSOO-CXDRUV-20231108122035

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 545620287
Report Date: 11/08/2023
Date Signed: 11/08/2023 12:20:48 PM

Document Has Been Signed on 11/08/2023 12:20 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	PEREZ, MARTHA FAMILY CHILD CARE		FACILITY NUMBER:	545620287
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	11/08/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Martha Perez		TIME COMPLETED:	12:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 11/8/2023, Licensing Program Manager (LPM), Susie Fanning and Licensing Program Analyst (LPA), Claribel Soto met with Applicant, Martha Perez for a pre-licensing inspection. Applicant, her husband/assistant, and two minor children reside in the home. Background clearances were discussed and all adults currently living in the home and/or providing care and supervision to children have a criminal record clearance and/or exemption. Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed: · This is a single story home and children will have access to the living room, kitchen, bathroom, bedroom and backyard patio. Off-limits rooms/closets are made inaccessible by use of door spinners or key locks. Care and supervision will be provided in living room. · There is a fireplace in the living room that applicant states will not be used during day-care hours and is made inaccessible by a screen. There is central air heating/cooling ventilation for safety and comfort. · LPA observed child size furniture. There is a flat screen television mounted onto the living room wall. There is a parents board on the living room wall. Children will nap in the living room on cots. Infants will nap in play yards. Children will nap in living room. Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Sleeping Plan and Safe Sleep handout. · Facility has 2A10BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place. · Applicant’s Pediatric CPR and First Aid certification was completed through American Red Cross Training Services and expires on 10/2/2024. · Preventative Health and Safety Training with Prevention of Lead exposure certification was completed on 6/29/2023. Continued on 809-C

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Claribel Soto
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: PEREZ, MARTHA FAMILY CHILD CARE	FACILITY NUMBER: 545620287
	VISIT DATE: 11/08/2023

NARRATIVE

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·Knives and medications are stored inside an inaccessible kitchen cabinet. Cleaning compounds are stored in an inaccessible hallway cabinet.
· Advised applicant fire and disaster drills are to be conducted at least once every 6 months and must be documented with date and time. A fire drill log was provided as an example.
· Applicant is advised at least one staff member with current training in pediatric first aid and pediatric CPR is to be on site at all times children are present or if children are being transported.
· There are no bodies of water at this home.
· There are six small dogs that are kept outside. Applicant is advised it is her responsibility to ensure the safety of children in care at all times around the pets as well as keep all accessible areas free of pet feces.
· Applicant states there are no firearms or ammunition in the home or on the premises.
· Applicant is reminded that any advertising (of day-care) such as business cards, flyers/posters, and/or signs must include facility number as per Title 22 Regulation "Advertisements and License Number" 102359 (a).
· Applicant is advised that smoking is prohibited on the premises of a family child care home as specified in Health and Safety Code Section 1596.795(a). Applicant states the home is smoke and vape free.
· Applicant states she will not be transporting day care children at this time. Applicant understands that she must have proper car restraints and/or car seats for all the children under her care when transporting children.
· Fenced backyard has a cemented patio that will be used for the children. If any other portion of the backyard is planned to be used for children, applicant will contact Community Care Licensing to have an inspection completed before using.
· SB 792 immunizations verified and on file.
· Applicant completed Mandated Reporter Training on 6/23/2023. The required training can be found at www.ccld.ca.gov. This training is required to be completed/renewed every two years.
· LPA discussed safe sleep regulations and Safe Sleep Regulation Concepts were given to applicant.
· Incidental Medical Services (IMS) policy was discussed. Incidental Medical Services (IMS) are not currently being provided. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383.

Continued on 809-C

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Claribel Soto
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: PEREZ, MARTHA FAMILY CHILD CARE	FACILITY NUMBER: 545620287
	VISIT DATE: 11/08/2023

NARRATIVE

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Required postings, forms packet, which included Parent Notification Requirement and LIC9224 were provided and discussed in detail. Applicant is advised that she may access CCLD website at www.ccld.ca.gov for additional forms and licensing updates. Applicant is also reminded that it is her responsibility to read the regulations periodically. Applicant states she will operate her day care Sunday through Saturday from 5:00 am to 6:00 pm and as arranged. No overnight care will be provided.

LPA & applicant discussed the Community Care Licensing website: LPA and applicant discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN.

Corrections needed prior to licensure:
Applicant is advised the following items must be corrected and documentation be sent to Fresno CCL within the next 30 days to avoid possible withdrawal of application

· Bathroom cabinets needs to be made inaccessible.
· Outdoor patio fly problem needs to be resolved.
· Master Bedroom needs to be made inaccessible

Pending verification of corrections of the above items and a final review of her application, licensure as a Small Family Day Care Home capacity of 8 children ages under 18 years will be recommended.

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Claribel Soto
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023

LIC809 (FAS) - (06/04)

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